Latent Autoimmune Diabetes of Adults is VERY often confused with Type 1 by many health physicians and Diabetes specialists. And exactly HOW many people with Latent Autoimmune Diabetes are there is unknown - the numbers are between three million to ten million people who carry LADA. This condition has insulin resistance, like Type 2 Diabetes has, except there's autoimmunity associated. Unlike many with Type 2 Diabetes, all with LADA will have to inject insulin (numerous studies say the injections happen between three and 12 years past a Diabetes diagnosis). Latent Autoimmune has the same risk of cardiovascular problems, strokes and foot troubles as Type 2 Diabetes.
LADA is an autoimmune condition, and is often confused with Type 2 diabetes, however it is actually a variant of type 1 (autoimmune diabetes), which develops fairly slowly compared to Type 1, which can develop very quickly.
Like Type 1, LADA presents as an insulin deficiency (due to Beta cell destruction), whereas Type 2 is not an insulin deficiency but rather resistance to insulin (and insulin levels may be very high, at least in the early years). Note: Type 1 is not just a disease of children but can happen at any age.
LADA may occur in thin and fat people, but there should be a strong index of suspicion if a younger, thin and active person is found to have diabetes.
However, it does not typically have insulin resistance as a feature and hence the insulin sensitising drugs typically do not work / do not work very well. In many cases, people may be seen as 'non-compliant' becuase their blood sugars remain high or even deteriorate when given oral medications.
Where many people with Type 2, are overweight and show other typical features such as high blood pressure, high cholesterol, these may not be present in people with LADA.
It is recommended that persons diagnosed with LADA start insulin early, in an effort to preserve beta (insulin excreting cells) function as long as possible.
Numerous studies point out the connection between insulin resistance and LADA. The primary reason that I'm writing this is due to the fact there are some people I know - one person is Billie: she worked at University of Iowa Hospitals and Clinics. She was diagnosed with Type 2 Diabetes in Jun 2008, although more likely she carries LADA. The reason I say is because for many people, Type 2 will eventually turn into Type 1, according to her. I was inside the UIHC's psych ward in November 2009 where she was working at the time, and I presented some information about Latent Autoimmune Diabetes of Adults to her: she read the information, but then said her blood sugar was near 450 when she was diagnosed. She recently contacted me around September of 2012 and said that her sugars were really varying, sometimes going as high as the 216-247 range. I'm concerned for my friend Billie: she is 5'9" and around 184-191 pounds (she was never over 193), and I strongly suspect she has LADA. Please help me.
My research shows that LADA is typically not connected to insulin resistance (insulin resistance is typical to Type 2 diabetes not type 1 diabetes, of which LADA is a subtype). However, some people with Type 1 / LADA to go on to develop insulin resistance - so called Double Diabetes (where they have features of both type 1 and Type 2).
Type 2 doesn't turn into type 1, but over time their pancreas burns out and then they also become insulin deficient and have to inject insulin. Their insulin resistance means they often have to use very high doses of insulin (maybe as high as 100 or more units/day) to get control, compared to people with Type 1 who are also insulin deficient, but not insulin resistant (ie. a typical doses may be 30 units/day).
If your friend's blood sugars are that high she should be on Insulin. Is she on Insulin?
She should also have some further testing to better define what type of diabetes she has. This can include C-Peptide (if low it means that she is not producing much insulin), and antibody tests.
Latent Autoimmune Diabetes of Adults is not always clear cut: contrary to popular belief, some people with Latent Autoimmune Diabetes do represent with a family history of Type 2 Diabetes. Also, there are actually more people who have Latent Autoimmune than we recognize - conservative numbers put LADA people near 3.5 million to almost 4 million, although estimates run as high as 7.2 million. There may also be many more overall diabetics than we may realize (there could be around 42 million people who are diabetic in US alone, far more than conservative estimate of nearly 27 million.
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